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MEDICAL TERMINATION OF PREGNANCY.

Medical methods of terminating pregnancy have been available in Europe and China for several years as an alternative to surgical abortion. An approach using methotrexate and misoprostol has received some limited study recently. This report from the Mt. Sinai School of Medicine describes its safety and efficacy in 178 women who were no more than 63 days pregnant. The protocol consisted of intramuscular methotrexate (50 mg/m2) followed by intravaginal misoprostol (800 micrograms) 5 to 7 days later. The misoprostol could be given once more if there was no response. For incomplete expulsion, vacuum aspiration was performed. Abortions were successful in 96 percent of patients, and 88 percent occurred within 24 hours. Twenty-five women (14 percent) needed a second dose of misoprostol. In the seven cases requiring aspiration, pathologic examination showed changes consistent with inevitable abortion. No patient required blood transfusion, and there were no major complications. Acetominophen with codeine phosphate controlled pain adequately in almost all cases. Comment: This study demonstrates the relative safety, simplicity, and efficacy of medical abortion, and will surely fuel much social debate in the U.S.

— TL Schwenk

Published in Journal Watch General Medicine September 12, 1995

Citation(s):

Hausknecht RU. Methotrexate and misoprostol to terminate early pregnancy. N Engl J Med 1995 Aug 31 333 537-540.

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